Lincot J, Veillon F, Riehm S, Babay N, Matern J-F, Rock B, Dallaudière B, Meyer N
Department of Radiology I, Strasbourg Hautepierre University Hospital, CHRU Hautepierre, avenue Molière, 67098 Strasbourg cedex, France.
Department of Radiology I, Strasbourg Hautepierre University Hospital, CHRU Hautepierre, avenue Molière, 67098 Strasbourg cedex, France; Faculty of Medicine, Louis-Pasteur University, 67000 Strasbourg, France.
J Neuroradiol. 2015 Jul;42(4):193-201. doi: 10.1016/j.neurad.2014.02.003. Epub 2014 Jul 9.
To compare diagnostic performances for cholesteatoma diagnosis of incremental MRI protocols including non-echo planar diffusion-weighted imaging (DWI) performed on 3T and 1.5T scanners.
Thirty-nine patients with suspected cholesteatoma underwent 3T and 1.5T non-echo planar DWI and additional unenhanced T1-, delayed gadolinium-enhanced T1- and high-resolution T2-weighted standard acquisitions. Patients either underwent surgical tympanoplasty (n=21) or close clinicoradiological follow-up (n=18). Four radiologists independently and prospectively interpreted two incremental MRI protocols, differing in the magnetic field strength of the diffusion-weighted acquisition and comprising the three standard sequences. At each step, diagnostic performances were expressed as sensitivity, specificity, positive predictive value, negative predictive value and accuracy.
Forty middle ear lesions including 21 cholesteatomas were identified. Univariate and multivariate analysis did not demonstrate significant reader, sequence addition or DWI magnetic field effect on diagnostic performances. Concerning non-echo planar DWI alone, sensitivity, specificity, positive predictive value, negative predictive value and accuracy ranged between 90.5-100%, 68.4-100%, 76.9-100%, 90.0-100% and 82.5-95.0, respectively.
Non-echo planar DWI for cholesteatoma diagnosis can be performed on 1.5T or 3T scanners indifferently. High sensitivity and negative predictive value and relatively lower specificity and positive predictive value are achieved by a single non-echo planar DWI protocol.
比较在3T和1.5T扫描仪上进行的包括非回波平面扩散加权成像（DWI）在内的递增式MRI方案对胆脂瘤诊断的诊断性能。
39例疑似胆脂瘤患者接受了3T和1.5T非回波平面DWI检查以及额外的未增强T1加权、延迟钆增强T1加权和高分辨率T2加权标准采集。患者要么接受了手术鼓室成形术（n = 21），要么接受了密切的临床放射学随访（n = 18）。四名放射科医生独立且前瞻性地解读了两种递增式MRI方案，这两种方案在扩散加权采集的磁场强度上有所不同，且都包含三个标准序列。在每个步骤中，诊断性能以敏感性、特异性、阳性预测值、阴性预测值和准确性来表示。
共识别出40例中耳病变，其中包括21例胆脂瘤。单因素和多因素分析均未显示出读者、序列添加或DWI磁场对诊断性能有显著影响。仅就非回波平面DWI而言，敏感性、特异性、阳性预测值、阴性预测值和准确性分别在90.5 - 100%、68.4 - 100%、76.9 - 100%、90.0 - 100%和82.5 - 95.0之间。
用于胆脂瘤诊断的非回波平面DWI可在1.5T或3T扫描仪上无差别地进行。单一的非回波平面DWI方案可实现高敏感性和阴性预测值，以及相对较低的特异性和阳性预测值。
